Expert opinion on current and emerging treatments in dermatophytosis

R. D. Kharkar; Mukesh Girdhar; Gautam Banerjee; T. Salim; Manas Sen; Susmit Haldar; Karthikeyan .; Ajey Kedia; Lipy Gupta; Rajesh Katariya

doi:10.18203/issn.2455-4529.IntJResDermatol20214927

Authors

R. D. Kharkar Dr. Kharkar's Skin Clinic and Ziva Cosmetic Centre, Malad, Mumbai, Maharashtra, India
Mukesh Girdhar Dr Mukesh Girdhar's Skin Clinic, Anand Vihar, New Delhi, India
Gautam Banerjee HN Polyclinic, Shyambazar, Kolkata, West Bengal, India
T. Salim Cutis Institute of Dermatology & Aesthetic Sciences, Calicut, Kerala, India
Manas Sen Prayas Polyclinic, Park Street, Kolkata, West Bengal, India
Susmit Haldar Calcutta Skin Institute, Kankurgachi, Kolkata, West Bengal, India
Karthikeyan . Red Hills Skin and Hair clinic, Chennai, Tamil Nadu, India
Ajey Kedia Dr. Ajay Kedias Skin and Cosmetology Centre, Mumbai, Maharashtra, India
Lipy Gupta Green Park Family Medicine Clinic, Green Park, New Delhi, India
Rajesh Katariya Well Skin – The Hair and Skin Clinic, Indore, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20214927

Keywords:

Dermatophytosis, Tinea infection, Antifungal

Abstract

Dermatophytosis continues to be a worldwide public health problem, predominantly in developing countries like India. Early diagnosis and appropriate management are imperative to enhance patient outcomes and improve quality of life of individuals with dermatophytosis. Multiple focused group discussions involving 76 dermatologists across 36 cities in India were conducted to provide a consensus clinical viewpoint of expert dermatologists to gain insights toward effective diagnosis and management of Indian subjects with dermatophytosis. These discussions mainly aimed at reviewing current literature on prevalence, etiology, diagnosis and management of dermatophytosis and highlighting variations in diagnostic and treatment approaches in routine clinical practice. The current article summarizes the experts’ clinical viewpoint on overall management of dermatophytosis. Diagnosis of dermatophytosis involves clinical observation, microscopic examination and dermoscopy. Molecular techniques have certain advantages over conventional microscopy and culture methods but are associated with issues of cost and technique complexity. Oral itraconazole 200 mg–400 mg daily and terbinafine 500 mg/day could be considered for recalcitrant tinea infections. Topical azoles like luliconazole, sertaconazole, and terbinafine could be beneficial. A combination of oral and topical antifungal drugs is effective in patients with steroid-modified and difficult-to-treat tinea infections. Also, patient counselling and use of adjunctive therapies like antihistamines, retinoids, and moisturizers are essential for managing tinea infections.

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